Abstract: :
Purpose: The purpose of this pilot was to improve the screeningrates of diabetic retinopathy in selected Nova Scotian communitiesand to determine the number of individuals with unrecognizedand/or untreated sight threatening retinopathy.Methods: ThreeFirst Nations and three non-First Nations communities were selectedfor screening. The program adopted a community-based screeningapproach and used a mobile camera, ophthalmic photographer,local area nurses and trained volunteers. Referrals from healthcare professionals as well as self-referrals from persons withdiabetes, were accepted for the program.The screening examinationconsisted of patient consent and confidentiality explanation,standard visual acuity determination, blood pressure measurement,and fundus photography of 3 fields (in both eyes) using a standard,mydriatic 30º fundus camera. Independent evaluation of the processedslides was performed by 2 graders.Results: 449 people werescreened. 55% (249) had never had a dilated eye exam in thepast. 16% (73) were found to need further assessment by ophthalmology.63% (46) of this group were new referrals to ophthalmology;the remaining 37% (27) had been seen at least once before byan ophthalmologist or optometrist.Of the 73 individuals needingfurther assessment, 44% (32) were referred due to their levelof retinopathy (level 47 or worse by the modified ETDRS classification),30% (22) were referred due to inadequate photographs, 10% (7)were referred for findings suspicious of glaucoma and 16% (12)were referred for other findings. Blood pressure measurementswere found to be within the recommended diabetic limits in 30%of First Nations' individuals and 50% of non-First Nations'individuals.Conclusion: Preliminary results show this pilotproject is meeting its goals of improvement of retinopathy screeningrates and detection of vision threatening pathology.